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This Issue in the Journal
Preventability of pre-hospital trauma deaths in
southern New Zealand
James A Falconer This study was done on the pre-hospital preventability of
trauma deaths in New Zealand as no similar study has been done despite trauma
being a leading cause of death in this country. Post-mortem reports were
examined and scored with a well recognised scoring system to determine
preventability of the deaths in the study region (Otago and Southland from 2000
to 2004). Most of the study population was found to have multiple anatomical
regions injured, with the head and chest the most frequently fatally injured
regions. Most deaths were in males under the age of 35, and the majority of the
study population died as a result of motor vehicle accidents. The majority of
the study population had non-survivable injuries however nearly half (45%) had
either survivable (10%) or potentially survivable injuries (35%). This is
similar to other comparable international studies.
Patterns of lower limb fractures sustained during
snowsports in Otago, New Zealand
Alistair Patton, James Bourne, Jean-Claude Theis We describe the nature and circumstances of leg fractures
sustained during skiing and snowboarding, that required operative fixation at a
single orthopaedic unit in New Zealand from 2002 to 2008.
Ethnicity of severe trauma patients: results of a
population based study, Auckland, New Zealand 2004
Gowan Creamer, Ian Civil, Alex Ng, David Adams, Shas Čačala , Timothy Koelmeyer, John Thompson Ethnicity is a factor in severe injury and mortality (death)
rates in Auckland. Our study findings show that Māori and Pacific people
had increased risk of severe injury and injury-related mortality in 2004.
Intensive care triage in Australia and New
Zealand
Paul J Young, Richard Arnold We conducted a web-based survey of Australian and New
Zealand intensive care doctors measuring demographics, details of recent triage
decisions and attitudes towards various triage scenarios. This survey
demonstrated that there are significant differences between the views of
intensive care practitioners in Australia and those in New Zealand with respect
to a range of common intensive care triage scenarios with those in New Zealand
tending to be more selective in their admission criteria. Despite these
differences, we did not demonstrate any difference in the proportion of
referrals to the intensive care unit that were refused.
Illness severity scoring for Intensive Care at
Middlemore Hospital, New Zealand: past and future
Susan L Mann, Mark R Marshall, Alec Holt, Brendon Woodford, Anthony B Williams Scoring systems are one of the tools used in intensive care
to allow study of progress in medical techniques and treatment over time.
Middlemore Hospital caters for a unique population, and this is reflected in the
diverse nature of admissions to our intensive care unit. Until recently, we have
relied upon an international gold-standard scoring system to help us benchmark
the outcomes we are achieving in our intensive care unit. In this study we show
how this scoring system has become less helpful over time. We suggest some new
approaches that might provide a more realistic reflection of practice and
outcomes in our population.
Capturing outcomes following injury: a New Zealand
pilot study
Sarah Derrett, Gabrielle Davie, Shanthi Ameratunga, John Langley To identify ways of improving outcomes after injury we need
to know what promotes good outcomes and reduces poor outcomes. Few studies have
followed the impact of injury on individual New Zealanders over time. We were
unsure if injured New Zealanders would be willing to take part in a study of
outcome following injury if the initial invitation came from their
insurer—the ACC. Two-thirds of eligible people contacted were willing to
take part in a pilot study and participants included those with a range of
injury types and causes. Following the pilot study, improvements were made to
the main ‘Prospective Outcomes of Injury Study’ which is now
underway.
Unintentional falls at home among young and
middle-aged New Zealanders resulting in hospital admission or death: context and
characteristics
Bridget Kool, Shanthi Ameratunga, Wayne Hazell, Alex Ng This study describes the characteristics and contexts of
unintentional falls at home among adults aged 25–59 years that resulted in
admission to hospital or death during a 12-month period in Auckland, New
Zealand. Of the 335 people who fell during the 12 month period and agreed to be
interviewed (in the case of death or major injury a family member was
interviewed), 36% fell on stairs/steps, 31% fell on the same level, 13% of falls
involved ladders or scaffolding, and 11% fell from buildings or structures. The
majority of falls (81%) occurred in the individual’s own home. While this
analysis was not designed to identify the specific causes of falls, 24% of
participants had consumed ≥2 drinks in the 6-hours preceding the fall, and
24% were on ≥2 prescription medications. The findings reveal several
important contextual factors that can be targeted to prevent fatal and serious
non-fatal falls at home among this age group.
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